| NPI | 1619107042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX T0306) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: KY 47974) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2021-07-15 |